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Author Topic: Cuts and their Treatment  (Read 8426 times)
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qwert
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« Reply #15 on: 14 June 2007, 06:57:08 »

Sorry about forgetting to say this before but I meant have the weapon experts work with our Aurora to figure out what damage the weapons did and possibly if that works update the current weapons with that information
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Aurora Damall
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« Reply #16 on: 18 June 2007, 23:03:46 »

Ok, I've finally got this entry done. So feel free to comment. grin
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qwert
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« Reply #17 on: 19 June 2007, 00:37:25 »

I have to say with how good this entry of yours is I'm suprised it isn't already added to the webite.
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Artimidor Federkiel
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« Reply #18 on: 19 June 2007, 04:55:41 »

Here some comments:

- I guess one can clearly hear the voice of an experienced mom here, as there are quite a lot of references on children in the entry. In general that is too much however for my taste, as you have to consider - as I already mentioned - that a middle age scenario is much rougher than today's world and the focus should be on wounds afflicted on adults with weapons which do cuts.

Children, if at all in some passages, should be mentioned last in this entry, not as the first thing in each section (it's fine at the smaller wounds, but later it becomes irritating). Here e.g.

Quote
A deep slash is where actual fatality becomes a distinct possibility, especially for children. Deep Slashes are to the point where pain becomes quite severe, and nearly unbearable for children. Although this cut is quite unlikely to happen to children, it's very possible in battle to get this slash.

...starting with chiildren and following it through is not appropriate. Deep slashes are typical battlefield wounds and this of course has to be the mentioned before everything else. Sometimes I have the feeling that it's all about children, and the rest is addition. That's not so good.

- One should also consider to make one single section out of some sections, because they are quite similar and vary only a bit. It's not necessary to go into detail everywhere and get repetitive too much.

- The information you gathered I guess is ok, but our Doc surely knows more on that. I'd let myself be treated by you, however, I have that much trust :)

- The Santhariarization still lacks a bit. The cleaning part in order to prevent bad spirits from entering I like, though I would explicitly anchor that as superstition, perhaps even make it a local one. Or create some lore surrounding it, e.g. Eyelian lore, these are very Red Indian based, and spirits might play a role here.

- Concerning a fatal blow I guess there's a point where you can bring in Santharian lore. At such heavy wounds the person usually blacks out, and here you could mention the Kiivosh, a typical way of getting the rather technical thing of consciousness into a fantastical concept. This surely has a place here.
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Kelancey the Green
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« Reply #19 on: 19 June 2007, 10:20:18 »

  Congratulations, Aurora, this is taking shape nicely!  This is getting to the depth where it will be widely used on an everday basis, so please be *really* careful with the nitpicking details here.  Please forgive me if I'm blunt or overly critical with my comments.
  Also, before I bluster through your beautiful entry like a bull in a china shop: Would you mind if I offered some friendly contributions here and there?

"Cuts and Slashes and their Treatment
...Most people get their first cut during their childhood while frolicking around and from then on get many different wounds, scathes, and scratches."
"Scathes" technically means a burn or abrasion, so it might not fit so well in this entry.

"...Cleaning is usually the stage to prevent bad spirits from going in and entering the body through the cut; this is done by just simply washing it with water."
Well stated.  The Herbarium also refers to using Mil'no sap, Totit oil, and Ormelin (from the Redberry bush and others) to cleanse a wound.  Just some food for thought.

"...Bandaging is quite obviously used for covering and wrapping the wound, usually until no blood can seep through which can be supplemented by using the Yahrle ointment."
Right, well said!  As obvious as it sounds, the deadliest part of any wound (to a present-day Santharian healer) is the blood loss.

"Scratch...

"Cut...

"Deep Cuts
Most deep cuts will send many of children into a balling state, and is usually the point of irritation on adults. Deep cuts are usually [?--how about "prone to contagion"?], and require a little bit more care and treatment. Usually deep cuts will draw a few drops to a quater of a sip of blood, and can be quite painful although they are usually only temporary. They range from four grains to a nailsbreadth deep."
I have to wonder, when do Moms receive their Emergency Medicine training?  You're very good at categorizing wounds by their depth--well done. :)  I think Artimidor has a strong point, here.  Maybe you don't need to use children's reactions as the standard for every section, but for the first two sections it seemed endearing and kind of authentic for that choice of writing style. 

"Treatment
...Some people might eat a few Miyu beans, or apply a small amount of a salve made out of Miyu bean or Ice plant."
About the Miyu beans, remember that a lethal dose is 7 beans for most people, so "a few Miyu beans" might be a bit excessive if this doesn't require stitching.  If it helps at all, some other pain relievers--listed in very incomplete fashion--are here. 

"Slash
A slash is a more serious cut in many ways. Firstly if a child gets a slash in some way it can pose a serious problem, such as blood loss. For a slash can spill a sip of blood or more. Also some slashes on children can get close to the bone, which will require a trip to a professional. On adults a slash is quite painful, but most don't need to be taken to a healer. A slash can run up to one nailsbreadth to two nailsbreadth in depth...."
Again, though this will be applied to children and adults alike, you probably don't need to refer to them separately here.  And, if you're a pediatrician, well,...then...keep them separate! ;)
Also, if the treatments for deep cuts and slashes are so similar, how about combining them into a joint section, "Deep Cuts and Slashes", and make special note that they are distinguished by the depth of the wound but the treatment remains the same?


"Deep Slash
...This is also the first cut where surgical treatment is required. A deep slash may spill up to a tot of blood, and can range from three to four nailsbreadth in depth. Enough to cut off a small childs arm. Severe blood loss in children is also commonly seen in this type of cut.
One idea I wanted to run by you, which is, cuts can bleed varying amounts depending on where they occur on the body, can't they?  For example, a cut that's two grains deep on the sole of the foot would hardly be noticed.  That same cut on the protective fat of the back would ooze just a little, and would sting a tiny bit.  And, that same cut on the very richly supplied earlobe would bleed profusely, and could burn for a half hour or more, right?  Maybe?  Or, maybe not.

Also, "cutting off a small child's arm"?  Ew, that's kinda graphic!  buck


"Treatment
The deep slash is a very severe cut, and it is greatly advised that you go to a specialist, especially with children...."
This entry will likely be heavily read by specialists, or those training to become specialists.  How about, "...a very severe cut, best tended by specialists"?  Or, something like that.

"...Most healers, as soon as their patients come in with this cut, will quickly ["douse the wound with water, then"?] put a large amount of Yahrle ointment or Odea moss on the wound. Most healers will usually give the patient about four Miyu beans, as preperation for the surgery.  They will then immediately take the strands of a Silkel tree and quickly stich across the wound. After this they will heavily bandage the area, and most doctors will advise their patients to eat a few Miyu beans if the wound starts to hurt again.
This is purely a personal thing, so feel completely free to ignore this at a whim.  The entry on Silkel trees states that strips of bark can be prepared so they stick together to make silk.  My personal reason for not liking this as a suture thread is that any thread made of fibers that are glued together, and not naturally occurring as only one long strand, can come apart if enough tension is put on the thread, or tug, tear and widen the surgical wound as you pull the thread through.  I have no idea how sophisticated surgical technique is in present day Santharia, but I'd like to forward the idea that there are alternatives, such as Yuatu'way from the Totit plant, and the Lu'an moth makes a very fine silk-type cocoon.  Just a sidenote from one healer to another!  ;)

"Grievous Slash
A grevious slash is one of the most dangerous wounds, of which will probably not result in death with adults. Although in children a grevious slash can be quite deadly if not treated immediately, for this cut can go up to six nailsbreadth deep, enough to cut off a grown adults arm."
How would you feel about smushing these sentences together into, "A grievous slash can reach six nailsbreadth in depth, which, depending on the amount of blood loss, can result in death"?

"...real danger is in the blood loss, for up to two and a half tots of blood can be spilled. This cut is rarely seen however, for if a sword went this far it would probably travel even farther. This cut is sometimes fatal in adults but usually isn't, if seen by a healer."
These sentences seem extraneous; could this paragraph do without them?

"Treatment
A grevious slash can be quite deadly if not treated immediately, especially in children. A grevious slash is usually quickly washed [how about "rigorously" or "profusely"?] with water, and coated in lots of yahrle ointment...."

"...Although some poorer healers will use odea moss, this treatment is usually not as effective as Yahrle ointment however. After this usually some Miyu beans are eaten, and for even more pain reliever some doctors will apply Ice Plant paste to the wound."
I kinda have a different mental picture of what Miyu beans are like, and please correct me if I have completely the wrong concept here.  I don't see Miyu beans as being ingested the way we pop a couple of pain pills.  I kinda view them more like unit-doses of general-anesthesia-grade narcotics.  People probably can, and have, overdosed on Miyu beans in present-day Santharia.  Por'mon/Ice Plant salve is probably much less likely to cause an overdose, similar to modern-day topical Lidocaine.  Please tell me if I'm way wrong about this one!

"...Then the healer will take a large strand of silkel tree, and double stitch the wound.  This is done as a precaution, for the silkel thread might break. Then bandages are added and wrapped tightly...."
Well done, good insight into technique.

"Fatal Blow"
A blow can come from any instrument--blunt, piercing, or slashing.  However, your topic focuses on incisions from sharp instruments.  Would "Fatal Slash" or "Death-Dealing Gash" work?
A fatal blow is just as its name indicates, and is the highest degree of cut there is.  It is nearly a death sentence to a child, and to adults is seen at least as a permanent handicap and usually death..."
The second sentence seems extraneous, does it need to be there?

"...A fatal blow is most often inflicted by spears and swords, and is usually done in the chest or stomach.  For in most adults if it is inflicted in the arm or leg area it is usually a grevious slash, unless you have very thick legs or arms.  Fatal blows are measured from six nailsbreadth and up, and can draw almost all the blood in the body."
There are a bunch of cutting weapons in Santharia, many of which could cause a fatal injury, no?  And, severing a limb or gouging a major artery could also count as a fatal wound, couldn't it?

"Treatment
The treatment for a fatal blow is quite simple and sad. Most healers will not even try to save their patients. For this is seen as a futile struggle, and a waste of time and supplies. So most healers will overdose their patients on Miyu beans, and give them a painless quick death. Some healers will do this in a more brutal way however, and will slit their patients throat...."
No.  No, no, no; sorry, no.  I won't speak for all healers, but most healers won't willingly kill their patients.  Especially not when elixirs like ormelin and potion of the Arryi flower have properties which border on the miraculous for puncture wounds.  Those who willingly kill their patients, when there are remedies available that are thought to be effective, are greedy assassins wearing healers' robes, not healers!

"...If the healer trys to save the patient however, they will go through the same process that a grievous slash goes through."
The description for ormelin says to have a victim drink a deep sip of ormelin at the earliest opportunity.  Though smaller amounts may be applied directly on or into smaller wounds, ingesting the fluid is best for near-fatal or fatal punctures or slashes.

  This is a very meritorious entry, and very necessary to have on the website!  Great job on this one, Aurora!
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« Reply #20 on: 19 June 2007, 21:04:38 »

Small note:  my myrmex/ants are used in some places as primitive sutures and probably deserve a mention as such here...

And to Kel's second-last comment:  perhaps we need to have a Santharian Aesclepius or Hippocrates whom we can credit with a philosophy of medicine, such as 'First, do no harm'?   
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Kelancey the Green
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« Reply #21 on: 19 June 2007, 22:39:56 »

  Is there any tribe where a name of 'Galen' would fit in, after the Roman who stated, "Primum, non nocere"?
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Aurora Damall
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« Reply #22 on: 19 June 2007, 23:02:44 »

Ok, it's all fixed.  grin
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Artimidor Federkiel
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« Reply #23 on: 21 June 2007, 04:58:10 »

From what I see there were a bunch of changes in the entry, Aurora, and definitely a bunch of improvements. It's difficult to see exactly what was changed, though, as it wasn't marked.

But anyway, there are also some comments that obviously haven't found their way into this version, and I don't know if you still plan to adjust these things.

- E.g. the Treatment part at the Fatal Blows section, against which our Doc protests with good reasons I think. "Primum non nocere" means: "First, do no harm." And while it is not directly in the Hippocratic Oath, it has become a must for every healer. It means basically: If you can't help, make sure that it doesn't get worse. Well, this is not the place to discuss euthanasia - there might be certain Santharian healers as well, who favour it, but it shouldn't be the rule as is stated here.

- What about my Kiivosh suggestion? This could go right in this part. At serious injuries where the healer is helpless he/she might have to wait for the Kiivosh to decide upon the fate once everything is done by the healer.

- In order to avoid too many children references you could also mention youths an such. Because sentences like "Although in children a grevious slash can be quite deadly" still sounds a bit disturbing as such kind of violence against children is not even common in the dark Middle Ages. (Well, mostly at least!)

- The name "Galen" I'd write "Gallen" and could be probably a Sophronian one (I have some ideas on their name scheme), if you want to use that one for a similar quote that comes close to the mentioned "Primum non nocere"- that would be a nice easter egg. But the phrase needs to be different.

So, yeah, a few things to adjust are still needed, but it gets better and better, Aurora!  thumbup :D
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« Reply #24 on: 21 June 2007, 23:01:13 »

Ok, thank you very much, I'll start marking my changes again. About Galen, do you want me to mention that or the Bard. Now to adress the Kiivosh, Is it ok to say that doctors have seemed to find put that if the patient sees a black kiivosh pheonix the will die, but if they see the half fish half bird they'll live. Anyways thank you.
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« Reply #25 on: 22 June 2007, 03:25:27 »

Gal(l)en you can mention, I guess it would fit nicely.

On the Kiivosh: Well, you need to be careful here. The Kiivosh is a myth, so you can't say that people actually see it, they might more sense it or imagine it. You know, just as some tribes here on Earth believe that nightmares are caused by spirits that sit on the dreamer's breast having bad influence. Things like that. Or you might call it a near-death experience. Like people who see a tunnel of light - or "might" see a tunnel of light, because they believe that this is what they will see if they tie.

So a fallen soldier might say when waking up from unconsciousness: "I was as if I heard the heavy wings of the Kiivosh and then I felt it sitting on my breast. An aura of calm suddenly engulfed me as he held his guard." There's such a scene in an untranslated chapter of the Avaesthoría for example. Healers would use phrases with the Kiivosh as metaphors. Instead of saying: "He was unconscious for a while, and now he has died." they'd rather say: "I tried my best, but couldn't help him anymore and sensed the Kiivosh on him, standing final guard. Then, after a while I saw his face change. The Kiivosh had taken his prey." - Know what I mean?
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Alysse the Likely
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« Reply #26 on: 22 June 2007, 09:47:01 »

Just a note on how we might handle the "euthanasia" idea.

Perhaps we should say that this may be done only if the following applies:

The patient requests it (he/she might see this as better than being horribly, permanently crippled, or dying in agony)

AND

The patient's family (if any) agrees to this.  (Other caveats may apply as the situation demands)

And then it would be done with a handful of those beans or perhaps a brew of some sort (assuming your patient can swallow)

Just so there are no misunderstandings--I am not expressing my personal views on euthanasia here, simply making a recommendations on how we might handle the idea.  I think it's a possibility for Santharia because medieval people were a bit more "at home" with death than we are today.  Most of them would have been exposed to it and touched by it at an early age.  Woman frequently died in childbirth or lost a baby/child to some illness.  Men were often exposed to danger due to things such as wars, working with large animals or cattle, living in less sanitized conditions, and accidents such as cutting oneself with an axe or other  sharp tool. And people killed animals to eat as well.  They were not quite as frightened by the idea of dying as a modern person might be.

Anyway, that's my two sans,

Alysse
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Alysse the Likely
Kelancey the Green
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« Reply #27 on: 22 June 2007, 12:22:40 »

  Alysse, you have an excellent point, and overall I'd agree with you about the perspective on death and how healers fit into that scheme.  If you wouldn't mind a friendly "Yes, and..." to your idea, different ancient societies had different takes on physician-assisted suicide.  I think the Greeks in the time of Hippocrates had laws not prohibiting but regulating how euthanasia (or whatever term they used then) was to be performed.

  On the other hand, some other ancient civilization...was it the Egyptians?, sorry, I can't remember exactly who, had a law that if a patient under the care of a physician died, then the physician would be killed at that moment, right there on the spot!

  If we incorporate any particular official stance on this issue, my vote would be in the direction of "very cautiously okay with physician-assisted suicide", and I think your guiding principles are just the thing to ensure that it's exercised properly.
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« Reply #28 on: 22 June 2007, 12:56:26 »

I think that having different views for different tribes might be best, based on each tribes religious affiliation.  Remember, suicide in most catholic faiths is considered one of the most dire of sins, and assisted suicide lopped in with it.

Generally, I'm just against broad based generalities.  I like for multiple views in Caelereth to fight one another for dominance.  It adds layers of realism.
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« Reply #29 on: 23 June 2007, 01:11:50 »

@Altario:  Yes, that makes excellent sense--I was only thinking about the perspective of a typical Tharian healer.  Naturally other races than human would have their own perspectives, and different religious groups as well.  But I was proposing this as being the (Tharian) legal point of view, just so that we actually have one. 

@Kelancey:  Thanks, and of course I don't mind.  We can give brief mention to other groups as you and Altario suggest, but we should have a definite legal statement for the kingdom, and that was my focus.

Anybody can a should feel free to agree, comment on, or disagree with this, BTW. Remember, this is just my opinion here.  Art? Talia? Judy?   And of course, the author, Aurora? What do you think?

Alysse

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